Stress ulcer prophylaxis in children with status asthmaticus receiving systemic corticosteroids

a descriptive study assessing frequency of clinically important bleeding

Anthony A. Sochet, Sorany Son, Kelsey S. Ryan, Meghan Roddy, Eddie Barrie, Michael Wilsey, Scott D. McKinley, Thomas Nakagawa

Research output: Contribution to journalArticle

Abstract

Objective: To determine the frequency of clinically important bleeding (CIB) among children hospitalized for status asthmaticus with and without exposure to stress ulcer prophylaxis (SUP). Methods: We performed a single-center, retrospective cohort in 217 children admitted for asthma exacerbation aged 5–18 years from May 2015 to May 2017. We assessed cohorts with and without exposure to SUP to determine if differences in frequency of CIB exist. Study outcomes included frequency of CIB, gastrointestinal complications (occult bleeding, macroscopic bleeding, gastric perforation, and acquired gastritis), and SUP-related adverse events (ventilator associated pneumonia, C. difficile colitis, necrotizing enterocolitis, and acute thrombocytopenia). Results: Ninety-two (42%) children received SUP of which 82 were admitted to the pediatric intensive care unit (PICU). There were no differences in asthma severity or known risk factors for CIB in children with and without SUP in the PICU subcohort. We observed no CIB or SUP-related adverse events. Two subjects acquired gastritis in the no-SUP cohort and one additional subject experienced occult gastrointestinal bleeding with spontaneous symptom resolution. Conclusion: Children admitted for status asthmaticus with and without SUP had no observed incidence of CIB. In this specific population, we propose a prerequisite assessment for the presence of known stress ulcer related gastrointestinal bleeding risk factors prior to the blanket administration of SUP.

Original languageEnglish (US)
JournalJournal of Asthma
DOIs
StatePublished - Jan 1 2019

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Status Asthmaticus
Ulcer
Adrenal Cortex Hormones
Hemorrhage
Pediatric Intensive Care Units
Gastritis
Asthma
Ventilator-Associated Pneumonia
Necrotizing Enterocolitis
Hospitalized Child
Colitis
Thrombocytopenia
Stomach
Outcome Assessment (Health Care)

Keywords

  • gastritis
  • gastrointestinal bleeding
  • Pediatric intensive care unit
  • steroids

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine

Cite this

Stress ulcer prophylaxis in children with status asthmaticus receiving systemic corticosteroids : a descriptive study assessing frequency of clinically important bleeding. / Sochet, Anthony A.; Son, Sorany; Ryan, Kelsey S.; Roddy, Meghan; Barrie, Eddie; Wilsey, Michael; McKinley, Scott D.; Nakagawa, Thomas.

In: Journal of Asthma, 01.01.2019.

Research output: Contribution to journalArticle

Sochet, Anthony A. ; Son, Sorany ; Ryan, Kelsey S. ; Roddy, Meghan ; Barrie, Eddie ; Wilsey, Michael ; McKinley, Scott D. ; Nakagawa, Thomas. / Stress ulcer prophylaxis in children with status asthmaticus receiving systemic corticosteroids : a descriptive study assessing frequency of clinically important bleeding. In: Journal of Asthma. 2019.
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